Objective:To investigate the effects of Dexmedetomidine for supplemental anesthesia on perioperative hemodynamics and postoperative sedation and analgesia in elderly patients receiving radical gastric cancer surgery under general anesthesia.Methods:From January 2019 to April 2020, 63 patients admitted to our hospital for radical gastric cancer surgery were included as observation objects.They all underwent general anesthesia and were divided into the Dexmedetomidine group(odd-numbered group)and the normal saline group(even-numbered group)according to the parity of serial numbers the subjects were assigned to.Changes in perioperative hemodynamic index values and the amounts of anesthetic drugs used in the two groups were monitored and recorded, and postoperative sedation and analgesia effects were evaluated by using the Ramsay sedation scale and the visual analog scale(VAS).Results:The mean artery pressure(MAP)and heart rate(HR)were lower in the Dexmedetomidine group than in the normal saline group before anesthesia induction(T1), immediately after intubation(T3)and immediately after extubation(T5)( P<0.05). The Ramsay scores were higher and the VAS scores were lower in the Dexmedetomidine group than in the normal saline group at 1 h and 4 h after surgery( P<0.05). The doses of intraoperative propofol and remifentanil were lower in the Dexmedetomidine group than in the normal saline group[(1121.5±198.5)mg vs.(1395.6±332.7)mg, (3.1±0.9)mg vs.(5.5±1.2)mg, P<0.05]. Conclusions:The use of Dexmedetomidine for supplemental anesthesia can effectively maintain the stability of the patient's intraoperative hemodynamics and enhance the sedative and analgesic effects while reducing the amount of anesthetic drugs in patients receiving radical gastric cancer surgery under general anesthesia.

Objective Todetect the expressions of HGF ,C-met and NRP1 protein in osteosarcoma and to investigate their corre-lation and the clinical significance .Methods The postoperative preserved paraffin block and the clinical data in 70 cases of osteosar-coma were taken as the observation group and 50 cases of the parraffin block of mature bone tissue after decalcification and the clin-ical data were taken as the control group .The expressions of HGF ,C-met and NRP1 protein were detected by the immunohisto-chemistry(IHC) method for investigating their expressions in the tumor patients with different clinicopathological characteristics and analyzing their relationship .Results The positive rates of HGF ,C-met and NRP1 expressions in the observation group were higher than those in the control group .The positive rates of HGF ,C-met and NRP1 expressions in the observation group were cor-related with metastasis ,vascular invasion ,clinical stage and Ki67 expression .The positive relationship was found between the ex-pressions of HGF and C-met with NRP1 of neoplasm .Conclusion The high expressions of HGF ,C-met and NRP1 in osteosarcoma play the important role in the progress of tumor lesion .The postoperative combined detection of HGF ,C-met and NRP1 protein could have certain value to predict the prognosis .

Female ; Humans ; Infant ; Mitochondrial Proton-Translocating ATPases ; deficiency ; genetics ; Mutation

Objective To assess the efficacy and safety of intraoperative wake-up test during surgery for ossification of the ligamentum flavum(OLF). Methods Between June 2004 and June 2010,35 patients(23 males and 12 females,at age range of 32-71 years,mean 50.5 years) with OLF underwent posterior decompressive laminectomy and excision of OLF.The operation wag performed on the cervical vertebrae in four patients,on the thoracic vertebrae in 24 and on the lumbar spine in seven,with monosegmental OLF in 14 patients and multisegmental OLF in 21.The outcomes were evaluated using Japanese Orthopaedic Association (JOA) scale. Results The operation lasted for mean 190 minutes (120-260 minutes),with the blood loss for mean 350 ml (220-520 ml)and the mean 2.4(1-5) lamin receiving decompression.The follow-up period ranged from 6 to 72 months (mean 29.5 months).The JOA score was improved from 4.302±1.023 preoperatively to 8.327±1.032 at the final follow-up (P<0.01).The neurological symptoms was aggravated during operation in three patients,for whom the muscles force recovered gradually in two patients but one showed no change after special measures.No serious complication was found in the other patients postoperatively. Conclusions The wake-up test can serve as an effective monitoring during the procedure ofthe decompressive laninectomy in the patients with severe OLF and decrease the occurrence of neurologic deficit complications.

Objective To investigate the cytotoxic effects and mechanism of PNP-CD chimeric gene vector originated from PNP/MeP-dR system on HCC cells. Methods The fusion suicide gene PNP-CD obtained by site directed mutagenesis technique was subcloned into pcDNA3.0 to construct a eukaryotic expression vector containing a chimeric gene, pcDNA3.0/ PNP-CD. After being identified by recombinant enzyme, PCR and subsequent sequencing, it was transfected into HepG2 cells by liposome-mediation method. The G418-resistant cellular clone with stable transfection of pcDNA3.0/PNP-CD, HepG2/PNP-CD was established by selection. The expression of PNP-CD gene was also verified by RT-PCR and Western blotting. The curve of cellular growth was assayed by Trypan blue exclusion. The cellular sensitivity of HepG2/PNP-CD to its specific prodrugs and its bystander effects were also assayed by MTT method. Results The chimeric gene, PNP-CD, was inserted into pcDNA3.0 correctly, and the stable expression of pcDNA3.0/PNP-CD in HepG2 cells was confirmed.This cellular clone was highly sensitive to its corresponding prodrugs. It was indicated that its bystander effects with the synergetic treatment of its specific prodrugs were substantially higher than those caused by the same vector with the administration of only a single prodrug, MeP-dR. Conclusion The bi-functional fusion suicide gene vector, pcDNA3.0/PNP-CD, yields powerful cytotoxic effects on HCC cells in the presence of the synergetic treatment of its specific prodrugs, which would be a high-performance therapeutic vector in gene therapy for liver cancer.

Objective To evaluate angiography and interventional embolization in diagnosis and treatment of massive hemobilia.Methods During 10 years,9 patients with massive hemobilia underwent emergency selective hepatic artery angiography to find the bleeding points,and then embolized the feeding branches.Results All cases demonstrated clearly on angiography about the arterial hemorrhage,and extravasation of contrast-medium.Hemorrhage was stanched immediately after embolization of the feeding branches of the hepatic artery.Conclusion Selective hepatic angiography and interventional embolization for massive hemobilia is a safe and efficient diagnostic and therapeutic method.(J Intervent Radiol,2006,15:213-214)

Objective:To evaluate the efficacy and safety of combined cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with lobaplatin and docetaxel for treatment of synchronous peritoneal carcinomatosis (PC) from gastric cancer. Methods:Fifty patients with synchronous PC from gastric cancer were treated by 52 CRS+HIPEC procedures with 100 mg of lobaplatin and 120 mg of docetaxel in 12000 mL of normal saline at (43 ± 0.5)℃for 60 min. The primary and secondary endpoints were overall survival (OS) and perioperative safety profiles, respectively. Results:At a median follow-up of 22.5 months, the median OS rate was 14.3 (95%CI:7.6-21.0) months, and the 1-, 2-, and 3-year survival rates were 58%, 40%, and 32%, respectively. No perioperative deaths or serious adverse events occurred in 12 cases (23.1%). Multivariate analysis indicated that completeness of cytoreduction, nor-mality of perioperative tumor markers, and adjuvant chemotherapy of more than six cycles were independent predictors for improved survival. Conclusions:CRS+HIPEC with lobaplatin and docetaxel could improve the OS and ensure perioperative safety of patients with synchronous PC from gastric cancer.

Objective To compare the differences and characteristics of the dose distribution of the two optimization methods in the three dimensional brachytherapy,and provide the basis for clinieal treatment.Methods Excel 2007 was used to generate random number.And a total of 21 patients of cervical cancer were selected from those who have completed the treatment.Inverse simulated annealing optimization (IPSA) plans were designed for graphical optimization (GO) plans.The dose volume histogram (DVH) parameters of the targets (V100％,V150％) and the organs (D1 cm3,D2cm3) of the two methods were analyzed.Results The targets dose of both plans could meet the prescription requirements.There was no statistically significant difference in the dose parameters of all targets (P ＞ 0.05).The closes of D1 cm3 and D2cm3 in the bladder of IPSA plan were significantly lower than that of the GO plan (t =3.596,3.490,P ＜ 0.05).There was no statistically significant difference in the dose parameters of rectum (P ＞ 0.05).Conclusions For cervix brachytherapy,the GO and IPSA have no effect on targets dose,but IPSA optimization can reduce the maximum dose of bladder.

Objective To investigate the diagnostic value of anti-mutated citrullinated vimentin (anti-MCV) and anti-cyclic citrullinated peptide (anti-CCP) antibodies for ankylosing spondylitis (AS), and to establish a new diagnostic method of AS based on anti-citrullinated protein/peptide antibodies (ACPAs) detection.Methods Totally 121 AS patients(AS group), 97 rheumatoid arthritis(RA) patients (RA group)and 103 healthy people(control group) were enrolled for the detection of serum levels of anti-MCV and anti-CCP antibodies using ELISA method as a diagnostic test .HLA-B27 in AS patients was tested by flow cytometry , and RF-IgM in RA and AS patients was detected by immune rate nephelometry .Receiver operating characteristics ( ROC) curve was used to analyze the diagnostic value and to determine the cut-off value.Anti-MCV and anti-CCP antibodies among each group were compared by Mann-Whitney U test, Chi-square test or Fisher′s exact test was used to compare positive rate .Results The anti-MCV levels in AS group [11.60 ( 12.36-25.83 ) U/ml ] were significantly higher than control group [ 11.60 ( 8.41 -13.54)U/ml ],U=2 413,P <0.001, while the levels of anti-CCP had no difference between the two groups [AS group 6.22 (4.30 -8.07) U/ml], and control group [6.01 (3.77 -7.58) U/ml], respectively;U=5 421,P=0.094.The calculated area under the ROC curve of anti-MCV was 0.806,and 14.67 U/ml was the optimal cut-off value with sensitivity of 0.645 and specificity of 0.942.In both HLA-B27 positive and negative AS patients , anti-MCV antibodies levels and positive rate were significantly higher than control group using new cut-off value above (U =133.5, P =0.001; U =2 279.5,P <0.001). Sensitivity of the combination detection of anti-MCV and anti-CCP ( MCV+CCP-) or RF-IgM ( MCV+RF-) were 60.3%(73/121), 62.8% (76/121) and specificity were 89.7% (87/97), 90.7% (88/97) respectively in differential diagnosis of AS and RA , which were significantly higher than anti-MCV detection alone in specificity (16.5%,16/97).Conclusions Anti-MCV could be a new biomarker for the diagnosis of AS .With high sensitivity and specificity , anti-MCV has an equal diagnostic efficiency in HLA-B27 positive and negative AS patients using our new cut-off value.Additionally, the combination detection of anti-MCV and anti-CCP or RF-IgM could be an effective method for differential diagnosis of AS and RA .

Survivin is a protein that inhibits apoptosis and regulates cell division.The cDNA sequence of survivin was amplified by RT-PCR and sub-cloned into the prokaryotic expression vector pET-21b(+),followed by transformation into E.coli strain BL21(DE3) and induction with IPTG.The recombinant survivin protein fusing with 6?His tag was expressed in E.coli in the form of inclusion body at the expression level over 60% of the total cell protein.Results of Western blotting showed that recombinant survivin reacted specifically with anti-human survivin antibody.After gel filtration,the recombinant protein reached the purity over 95%,which facilitate the study of diagnosing and inhibitor agents targeting survivin.